DESCRIPTION: Hostility, depression/depressive personality, and socioeconomic status (SES) have all been shown to influence the risk of coronary heart disease (CHD). With the three factors have been studied separately in previous work, there is evidence that they are interrelated and there is reason to hypothesize that they would interact in a multiplicative fashion to dramatically increase risk when they are present in combination. Three studies are proposed that are designed to describe the interrelationships of these three psychosocial dimensions and document their joint impact on several health outcomes. Study 1 will take advantage of two existing databases to study over 3000 coronary artery disease patients who have been followed for over a decade. Both self-report and behavioral indicators of hostility and depression will be studied in combination with SES to predict survival while controlling for initial disease severity. These measures will also be used in analyses designed to discriminate the psychosocial profile of patients who died early in follow-up from those who died after five years. Data on health behavior profiles and medical care utilization will be examined to evaluate the possibility that those factors could account for the relationships between psychosocial characteristics and survival. Study 2 will examine the ability of depressive personality, hostility, and SES to jointly predict acute myocardial infarction (AMI) and mortality in a sample of 730 initially healthy people who have been followed for 30 years. It will also investigate the associations of these psychosocial measures with changes in risk factor patterns and health indicators over the follow-up period. Study 3 will administer a large battery of measures to community volunteers in order to document the interrelationships between hostility, depressive personality, and SES in detail. These measures will also be used to predict the magnitude and duration of cardiovascular reactivity to mood induction tasks.